Meng Jin1, Xiaoyin Bai1, Xuanfu Chen1, Huimin Zhang1, Bo Lu1, Yi Li2, Yamin Lai1, Jiaming Qian3, Hong Yang4. 1. Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China. 2. Department of Emergency Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China. 3. Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China. Electronic address: qianjiaming1957@126.com. 4. Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China. Electronic address: YangH@pumch.cn.
Abstract
BACKGROUND: Acute pancreatitis (AP) is an acute inflammation of the pancreas, which caused increasing global health and economic burden. Longitudinal trends of disease etiology and its influence on prognosis remains unclear. OBJECTIVE: The aim of this study was to analyze the trend of etiology in moderately severe acute pancreatitis (MSAP) and severe acute pancreatitis (SAP) and to evaluate the influence of the changing pattern of etiology. METHODS: A 16-year cohort study was undertaken in a tertiary hospital. Patients who presented with MSAP or SAP from January 2001 to December 2016 were continuously enrolled. Demographic data, clinical manifestations, treatment strategy, and prognosis were recorded and verified. RESULTS: A total of 475 patients were included, among whom 173 (36.4%) had gallstone-associated pancreatitis and 108 (22.7%) had hypertriglyceridemia (HTG)-associated pancreatitis. The annual admission for MSAP and SAP rose steadily over the 16-year period (r = 0.907, P < .001), with an annually increasing proportion of HTG-associated pancreatitis (from 14.3% to 35.5%, r = 0.710, P = .015). Compared with gallstone-associated pancreatitis, hypertriglyceridemia-associated pancreatitis had significantly higher percentages of multiple organ dysfunction syndrome (MODS) (24.1% vs 12.1%, P = .009, FDR = 0.029) and cardiovascular failure (17.6% vs 4.6%, P < .001, FDR<0.001). Positive correlations were found between the annual proportion of HTG-associated pancreatitis and MODS (r = 0.574, P = .005) and between HTG-associated pancreatitis and cardiovascular failure (r = 0.512, P = .029). Regression analysis showed that HTG was an independent risk factor for both MODS (P = .004) and cardiovascular failure (P = .009). CONCLUSIONS: The number of annually admitted MSAP and SAP cases increased during the last 16 years along with an increasing proportion of HTG-associated AP. The increasing trend of HTG-associated AP might contribute to more frequently occurring MODS and cardiovascular failure.
BACKGROUND: Acute pancreatitis (AP) is an acute inflammation of the pancreas, which caused increasing global health and economic burden. Longitudinal trends of disease etiology and its influence on prognosis remains unclear. OBJECTIVE: The aim of this study was to analyze the trend of etiology in moderately severe acute pancreatitis (MSAP) and severe acute pancreatitis (SAP) and to evaluate the influence of the changing pattern of etiology. METHODS: A 16-year cohort study was undertaken in a tertiary hospital. Patients who presented with MSAP or SAP from January 2001 to December 2016 were continuously enrolled. Demographic data, clinical manifestations, treatment strategy, and prognosis were recorded and verified. RESULTS: A total of 475 patients were included, among whom 173 (36.4%) had gallstone-associated pancreatitis and 108 (22.7%) had hypertriglyceridemia (HTG)-associated pancreatitis. The annual admission for MSAP and SAP rose steadily over the 16-year period (r = 0.907, P < .001), with an annually increasing proportion of HTG-associated pancreatitis (from 14.3% to 35.5%, r = 0.710, P = .015). Compared with gallstone-associated pancreatitis, hypertriglyceridemia-associated pancreatitis had significantly higher percentages of multiple organ dysfunction syndrome (MODS) (24.1% vs 12.1%, P = .009, FDR = 0.029) and cardiovascular failure (17.6% vs 4.6%, P < .001, FDR<0.001). Positive correlations were found between the annual proportion of HTG-associated pancreatitis and MODS (r = 0.574, P = .005) and between HTG-associated pancreatitis and cardiovascular failure (r = 0.512, P = .029). Regression analysis showed that HTG was an independent risk factor for both MODS (P = .004) and cardiovascular failure (P = .009). CONCLUSIONS: The number of annually admitted MSAP and SAP cases increased during the last 16 years along with an increasing proportion of HTG-associated AP. The increasing trend of HTG-associated AP might contribute to more frequently occurring MODS and cardiovascular failure.